The leading cause of death of women between 18-44 is a ma she knows
Executive summary
Evidence does not support a blanket statement that “the leading cause of death of women aged 18–44 is a man she knows,” but it does show that homicide (an external cause) is one of the leading causes of death in that age bracket and that intimate partners or family members account for a large and sometimes dominant share of those killings in many contexts [1] [2] [3]. The truth is granular: intimate partner violence (IPV) is a major contributor to mortality and the burden of disease for women of reproductive age, but whether it ranks as the single top direct cause depends on the population, data definitions, and whether one counts contribution to disease burden versus direct cause of death [4] [5].
1. Homicide is among the leading causes of death for women under 45, but “leading” varies by metric
U.S. data identify homicide as one of the leading causes of death for women aged ≤44 years, making external causes a prominent source of mortality in this age group [1]; public-health charts from the CDC categorize leading causes across ages for females [6]. However, “leading cause” can mean absolute number of deaths, years of life lost, or contribution to the overall burden of disease, and different studies use different metrics — which is why some reports frame IPV as a top contributor to burden rather than the single direct killer [4].
2. Intimate partners account for a substantial share of female homicides — sometimes the majority
Multiple studies and national reports show that a very large fraction of women murdered are killed by someone known to them, often an intimate partner: U.S. law-enforcement data estimate roughly one-third of female murder victims are killed by an intimate partner (34% in 2021) [2], while other analyses and reviews report that intimate partners commit nearly half of female homicides in some data sets and a majority in specific countries or contexts [5] [7]. Globally, UN Women reports that 60% of women killed in 2025 were killed by intimate partners or family members, underscoring the scale of partner- or family-perpetrated killings worldwide [3].
3. For some subgroups and settings, femicide/IPV is the leading cause of premature death
Research has long identified femicide as a leading cause of premature death among specific demographic groups: earlier U.S. studies characterized femicide as the leading cause of death for young African American women (e.g., aged 15–34 or 15–45, depending on the study) and as a major cause of premature female mortality overall [8] [9]. Clinical and surgical societies have also warned that IPV is the leading cause of serious injury and death for women in late adolescence and early adulthood (ages 18–24) in the U.S. [10]. These subgroup findings show the danger of making one-size-fits-all claims across races, ages, and nations.
4. Many studies frame IPV as a contributor to disease burden, not always the proximate cause of death
Analyses that measure “burden of disease” — which aggregate deaths, disability, and long-term health impacts — often find that IPV contributes more to the disease burden in women 18–44 than single risk factors like tobacco or high cholesterol (a finding highlighted in Australian analyses), but that contribution is different from saying IPV is the top direct cause of death [4]. Likewise, IPV contributes to suicide and other fatal outcomes (an estimated share of suicides and homicides are IPV-related), which means counting only direct homicides understates the role of IPV in overall female mortality [5].
5. What this means for public understanding and policy
The consistent, cross-national pattern — whether in U.S. forensic reviews, global UN reporting, or autopsy-based studies in specific countries — is that men known to the victim, especially intimate partners, are disproportionately represented among perpetrators of women’s homicides and that IPV substantially raises women’s risk of severe injury, suicide, and death [11] [12]. Advocacy organizations and public-health bodies emphasize this to justify prevention, legal, and clinical interventions; at the same time, some messaging compresses complex metrics into simpler claims that can overstate certainty [4]. The available reporting does not support an unconditional, universal claim that a male intimate partner is the single leading cause of death for all women aged 18–44 everywhere, but it does show that intimate partners are a leading perpetrator of homicides and a primary contributor to mortality and disease burden in many populations [2] [3] [4].